• E-mail
• Print
• Comment
• Font Size
• Digg
• del.icio.us
• Discuss article

Expensive Toy or the Secret of a Long Life? ; Alice Hart-Davis Investigates the High-Tech Scanner That Can Spot Heart Disease or Cancer Before It Kills You

Posted on: Tuesday, 2 November 2004, 18:00 CST

WHEN Martin Saville was offered an expensive, high-tech scan in September as part of a company health check, he almost didn't take it up.

At 54, he has no family history of heart disease. He doesn't smoke, isn't overweight, and when not busy working for a computer company in London, plays veterans' rugby to stay fit.

But then the scan revealed him to be in the riskiest 10 per cent for future heart trouble, with calcified deposits in his arteries. He was, to say the least, surprised. "I'm generally in good health and didn't have any symptoms.

But they found that I am at some risk and I had to ask if it was OK to go on playing rugby.

Fortunately they said I could."

It is stories such as this which are making the Electron Beam Computed Tomography scanner the capital's hot topic at dinner parties. Instead of house prices, the middle classes are discussing the pros and cons of paying hundreds of pounds for earlywarning scanning for heart disease, bone-thinning and various cancers.

Given that many conditions only materialise when it is too late to do anything to save your life, the excitement among stressed fiftysomethings is easy to understand.

The Pounds 2 million, state-of-the-art imaging machine takes glorious, three-dimensional colour pictures of the body's organs. These pictures are so detailed that you can see minute tumours of no more than 2mm in diameter.

Disease prevention has never been more glamorous.

Not surprisingly, the service is proving popular with the rich and worried - some might say hypochondriacal - as well as corporate healthcare services.

The machine at the European Scanning Clinic in Harley Street is the newest, most accurate device of its kind, and the only one in the UK. In the fraction of a second between heartbeats, the machine can capture an image more detailed than any X-ray of different parts of the body.

Heart scans, which look for signs of early calcification of the arteries, are most in demand. Heart disease is often thought of as a silent killer: in one in three cases, the sufferer has no warning before a fatal heart attack.

The EBCT scan, however, can spot indications of the disease - either in the form of calcified deposits on the artery walls, or changes in the artery walls which may indicate future calcification, 10 or 15 years hence. If you get the all-clear from one of these scans, you can be 97 per cent sure that you won't suffer coronary failure in the next 10 years.

And if the scan finds problems, you should have time to adjust your lifestyle through diet and exercise or, if the condition appears more advanced, to tackle it with medication.

The EBCT is the only technology to have been approved by the American Food and Drug Administration for heart scans because of its speed and accuracy.

Whereas some CT scanners have moving parts, this one generates a beam of electrons which are swept under the scanner, up through the body and detected by the ring above the scanner. This means it is very fast, which lessens the dose of radiation. But one downside is that an EBCT heart scan gives you 10 times as much radiation as a chest X-ray; a lung scan, about three times as much.

As well as heart scans, lung scans are offered, as are virtual colonoscopies (which look for polyps in the colon, an indicator of colon cancer), bone-mineral density scans and electron beam angiograms (to examine the coronary arteries supplying blood to the heart muscle or to the legs for signs of narrowing).

Abdominal scans can check the liver, spleen, pancreas, adrenal glands, aorta, kidneys and lymph glands, while an additional pelvic scan will include the bladder, pelvic lymph glands, uterus and ovaries or prostate gland.

The prevention-is-better-than-cure lobby is flagging the machine as the panacea for all modern ills, and looks forward to a time when there is one in every high street and people actively seek to find out about their health, rather than allow degenerative illnesses to creep up on them.

At the moment, however, this is only for people with money. Prices start at Pounds 200 for a bone-mineral density scan and rise through Pounds 500 for a heart scan to Pounds 1,000 for a virtual colonoscopy. If you fork out Pounds 1,900, you can have the full works of screening - heart, lungs, abdomen, pelvis and colon.

THE European Scanning Clinic is busy, with onethird of its clients bringing themselves along for a pre-emptive check-up. The rest are people referred by their doctors and corporate health- check clients.

When offered a scan at the clinic, I opt to have my lungs examined. Since I'm reasonably fit and under 45, I hope there's not a great deal wrong with my heart. Nor my lungs, come to that.

No preparation is needed, except that I mustn't wear a bra with metal bits in it, so I simply lie on the padded table which is retracted towards the open arch of the scanner.

I put my arms above my head and twice hold my breath while the machine takes scans - one straight through the chest, and one in section - and that's it.

The procedure has taken less than 10 minutes. Were I here for a heart scan, I'd wait for 20 minutes while the results were computed, then have a debriefing with a radiographer who is well-trained in how to dispense bad news sympathetically, in the unusual event of that being necessary.

In my case, the results will be sent out in the post later. They arrive the following morning. The pictures are lovely - even the smallest airways can be seen in great clarity - but I can't understand much of the text, so call my GP to talk it through.

There is, says the report, no evidence of any significant nodules within the lungs or abnormality of the lining of the lungs, which is good news. I have no "mediastinal lymphadenopathy" - ie no enlarged lymph nodes in the area between the heart and lungs, says my GP, which is where early cancer might manifest itself. Phew.

But in the right middle lobe of the lung the scan detected an area of "early consolidation which is most likely to represent infective change".

That doesn't sound good but, says my GP, that might be no more than visible evidence of the throat and chest virus which had just knocked me sideways.

The big question, of course, is whether all this is of any real benefit.

There are those with doubts, as you can see in the panel on the facing page, but those promoting the scanner are persuasive. "If you have a family history of heart disease, you can find out how you stand, which could put your mind at rest," says a spokesperson for the clinic.

"People say to us afterwards that they had been planning to go on holiday, but were so glad that they spent their money on a heart scan instead.

You can spend Pounds 500 to put your car through an MoT; why not MoT your most valuable asset, your body?"

Bupa is now recommending EBCT as part of health assessments for men aged 35-65 and women aged 45-70. "It is particularly appropriate for people who lead a stressful life, are overweight or smoke, have raised cholesterol or are diabetic," says Bupa Wellness head of marketing Peter Smythe.

. European Scanning Centre, 68 Harley Street, W1, 020 7436 5755.

www.europeanscanning.co.uk

'IT COULD CAUSE NEEDLESS WORRY'

THE trend for private computed tomography scans began in America, where there was overcapacity in CT units. But according to sceptics, the value of these scans is something only the individual can decide.

"It's a two-edged sword," says Professor Wladyslaw Gedroyc, director of the MRI unit at St Mary's, Paddington.

"The evidence that these check-ups do any good is pretty shaky.

"Yes, you may find someone with a little lung nodule which was a cancer in evolution, and you take it out and they have no more problems. That's terrific.

"But there are also patients who have unnecessary procedures because the scan shows something indeterminate, which might have been a natural variant.

If, say, an adrenal mass is found in the upper abdomen, people go through all sorts of further tests, but then it proves to be just an incidental thing, and nothing harmful."

Source: Evening Standard; London (UK)

More News in this Category